a stepThe discharge summary

A document handed over at discharge that states what was done. It is the only clinical record of the episode that travels with the patient, and the doctor who reads it next was not party to the consent, did not choose the implant, and cannot telephone the theatre.

Even inside one national system the handover is imperfect. A 2025 review of discharge communication to primary care reports that general practitioners criticise summaries for missing relevant content, and cites work finding that GPs and hospital doctors disagreed about whether the summary had done its job in 44% of cases. That is with a shared language, a shared record system and a shared regulator.

The cross-border version removes all three. The CDC Yellow Book's instruction is to "request copies of their overseas medical records in English" and to give them to whoever provides follow-up, and it cites the American College of Surgeons on obtaining "a complete set of medical records before returning home". Inside the EU the entitlement is statutory: the Member State of treatment must ensure patients are "entitled to a written or electronic medical record" of the treatment and "access to at least a copy of this record" (Directive 2011/24/EU, Article 4(2)(f)).

Inference — what makes a summary usable later is specific and frequently absent: the make, model and serial number of any implant, which decides whether a revision at home can be planned; the operation note rather than a discharge narrative; the anaesthetic record; drugs given and drugs sent home, in generic names rather than local brands; any culture taken and its result; results still pending when the patient boarded; and a named contact who will answer a question in six weeks. A summary with the brand names of one country's formulary is a summary that has to be decoded before it can be acted on.

The document is issued by the treating hospital in its own language and its own format. Translation is nobody's contractual duty unless the package says so. Trade practice — larger international departments issue an English summary as a matter of course, and smaller clinics issue whatever their system prints.

What a reader would have to ask: whether the summary will be in a language the home clinician reads, whether the operation note and the implant identifiers are included, whether pending results will be sent and to whom, and who at the hospital answers a clinical question after the patient has left the country.

As of 16 September 2026 no cross-border standard this project could find specifies what a discharge summary given to a foreign patient must contain. The EU entitlement is to a copy of the record, not to a record that meets a content standard.